Low Back Pain

Lower back pain is unfortunately common, with 20% of Americans reporting that they experience back pain every year. Men and women have been shown to equally experience it, and it can strike at any age. First episodes of back pain tend to take place between the ages of 20 and 40. Many times resulting in the need to consult with a Spine Surgeon.

Causes/Predisposing Factors

Back pain tends to arise from either the natural aging process, or mechanical issues. A small number of cases are caused by more serious illness. Back pain is commonly caused by aging or natural degeneration (osteoarthritis), mechanical issues such as herniated discs, muscle strain, and fractures associated with osteoporosis. Rare but serious causes include infection, vascular problems, cancer and damage to nervous tissues. Poor diet, lack of exercise, alcohol, drugs and tobacco have been shown to be back pain risk factors.

In order to make an effort to prevent back pain before it starts, try modifying or avoiding these risk factors, limiting repetitive motions like twisting, bending and heavy lifting, and by treating depression and obesity.

Symptoms

Back pain most commonly presents in the lower back, but it can also occur in the upper back. It may be intensified by movement, and it can radiate into the extremities, often the legs. Patients may also experience limits to their range of motion, or tenderness or soreness upon touch.

Diagnosis

A diagnosis of low back pain is made by a doctor after a physical examination is completed and a comprehensive history is taken. This diagnosis is what will begin the treatment process.

In order to identify issues like compressed nerves stemming from a herniated disc, a full neurological review can be performed. Supplemental imaging is used when symptoms persist after several weeks of treatment, or when a doctor has reason to suspect serious pathology. X-rays are ordered if a tumor or bone infection is suspected, while an MRI or CT scan is done when disc herniation is suspected.

Red flags that could indicate a more serious back condition include weakness, tingling or numbness, weight loss, fever, or bladder or bowel control issues. These symptoms may indicate the need for emergency care, and in some cases even surgery.

Treatment

As with most pain treatment, the goal of low back pain treatment is to relieve pain and improve function. Treatment methods range from conservative or nonsurgical treatments all the way to surgery. Fortunately, back pain tends to resolve on its own in a matter of weeks with nonsurgical treatment. This can include:

• Exercise and physical therapy to strengthen the back and core in order to quicken the recovery process and strengthen the back and core to avoid recurrence
• Lifestyle adjustments that work to reduce body mass and avoid aggravating motions
• Naturopathic therapies like acupuncture, yoga and massage
• Interventional pain treatments, including spinal cord stimulation and epidural steroid injections
• Over the counter pain-relief medications including ibuprofen, acetaminophen and muscle relaxants, or prescription pain-relief medications

If these conservative, nonsurgical treatment methods suggested by your doctor prove ineffective, steroids, opiates or local anesthetics can be injected at the pain site to keep pain signals from reaching the brain. Pain caused by disc herniation may require spinal fusion or discectomy, two forms of spinal surgery.